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  • Writer's pictureTom Cianflone

The Value of the 5 Star SEP

enrolling in medicare

If you are on a Medicare Advantage plan (MA plan, aka, Part C), you know that Medicare rules dictate when you can switch from one plan to another. The most widely known MA enrollment periods are the annual enrollment period (AEP) and the Medicare Advantage open enrollment period (OEP). For more information about them, see my blog posts All About AEP and All About Medicare Advantage OEP. Beyond those annually recurring enrollment periods, there are special enrollment periods (SEPs) that may be available to MA plan members. For general information about SEPs, see my blog post Special Enrollment Periods. In this post, we are talking in depth about one such SEP known as the 5 Star SEP.

What are Star Ratings?

Star ratings is how CMS (Centers for Medicare and Medicaid Services) rates MA plans available in each county, with 5 stars being the highest plan rating. Star ratings are based on the performance of MA plans in the following five areas: member experience with the health plan; customer service; plan performance; chronic conditions; staying healthy. Star ratings are given to specific plans in specific counties, not to insurance carriers in general. So it is common to see that a few plans in a specific county by a carrier may have a 5 Star rating while other plans by the same carrier do not.

CMS allows special access to 5 Star plans, and that is what the 5 Star SEP is all about.

What Does the 5 Star SEP Allow a Medicare Beneficiary To Do?

If there are 5 Star MA plans in your county, here's what the 5 Star SEP allows you to do:

  • Switch from any MA plan to a 5 Star plan

  • Switch from one 5 Star plan to another 5 Star Plan

  • Join a 5 Star plan if you're currently on Original Medicare

When Can the 5 Star SEP be Used?

The 5 Star SEP can be used only once between December 8 and November 30 of the following year. If you make a change using the 5 Star SEP, your new Medicare plan coverage will begin the first day of the month after your enrollment date.

What Carriers Have 5 Star Plans in Broward County, Florida, in 2024?

For 2024, the Broward County, Florida, 5 Star carriers in alphabetical order are:

  • Devoted Health, multiple plans

  • Humana, multiple plans

  • Optimum, multiple plans

  • Simply, multiple plans

  • UnitedHealthcare, one plan only

I'm happy to help you use the 5 Star SEP if you're contemplating a plan change. Contact me anytime.

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